Proceedings of the 2009 Winter Simulation Conference M. D. Rossetti, R. R. Hill, B. Johansson, A. Dunkin and R. G. Ingalls, eds. CONCEPT OF OPERATIONS FOR A REGIONAL TELEMEDICINE HUB TO IMPROVE MEDICAL EMERGENCY RESPONSE Hui Wang Wei Xiong Nathaniel Hupert Cayuga Partners LLC. Dept. of Public Health Dept. of Public Health Belle Mead, NJ 08502, USA Weill Cornell Medical College of Cornell University Weill Medical College of Cornell University New York, NY, 10065, USA New York, NY, 10065, USA Christian Sandrock Javeed Siddiqui Aaron Bair Division of Pulmonary and Critical Care Medicine Division of Infectious and Immunologic Diseases Division of Emergency Medicine UC Davis School of Medicine UC Davis School of Medicine UC Davis School of Medicine Sacramento, CA 95817, USA Sacramento, CA 95817, USA Sacramento, CA 95817, USA ABSTRACT Telemedicine (TM) is a tool that permits medical services to be provided remotely. Applications of telemedicine to disaster response began in the mid-1980s for natural disasters such as earthquakes, tsunamis, and hurricanes and for “staged” disas- ters in experiments and exercises. These activities led to the concept of a regional telemedicine hub (TMH) with an extended network of clinical providers, which potentially could alleviate problems associated with surge capacity during disaster re- sponse. However, health-related benefits associated with this organizational model for disaster-related telemedicine remain to be quantitatively tested. In this paper, we describe a simulation study used to examine the operation of a regional telemedi- cine hub during the acute phases of hospital patient management in a hypothetical earthquake scenario. We explore the im- pact of using telemedicine to provide emergency specialty care to expand surge capacities at both local and regional levels. 1 INTRODUCTION Natural and intentional disasters can unfold quickly and cause a variety of injuries to a large number of affected individuals, necessitating immediate and sustained medical care. While the timely extrication, stabilization, and transport of injured vic- tims of mass casualty incidents is a cornerstone of emergency medical and trauma care, medical responses are often impeded by the overwhelming number of patients and the limited number of available medical personnel and resources, resulting in delayed treatment. Major disasters such as earthquakes or hurricanes may also damage infrastructure within the affected area, such as communications facilities and roads, further impeding the delivery of medical personnel and material resources from external sources, including neighboring communities, humanitarian organizations, and State and federal sources. Telemedicine is a tool that permits medical services to be provided remotely. When equipped with the basic telecommu- nication devices that can be deployed by mobile units, responders on the scene of a disaster can quickly establish telemedi- cine linkages, potentially increasing both the speed and the capacity of medical responses when and where they are needed. Applications of telemedicine to disaster response began in the mid-1980s. Following the devastating 1985 Mexico City earthquake, NASA provided advanced satellite communication technology to support the international relief and rescue oper- ations (Simmons, Hamilton, and McDonald 2008). The U.S.-U.S.S.R. Space Bridge project provides a primary example of global telemedicine disaster assistance over time. After the 1988 Armenian earthquake telemedicine was employed to provide clinical consultation to several regional hospitals (Doarn et al. 2003; Simmons, Hamilton, and McDonald 2008). Into the 2000’s, telemedicine have been more widely used in various ways in response to disasters including earthquakes, tsunami 2809 978-1-4244-5771-7/09/$26.00 ©2009 IEEE